Blue‐Ribbon Boys: factors associated with PrEP use, ART use and undetectable viral load among gay app users across six regions of the world

Abstract

IntroductionGay social networking apps have grown in popularity among men who have sex with men offering opportunities for rapid and confidential collection of vital data as well as social connection. The goal of our study was to explore factors associated with utilization of pre‐exposure prophylaxis (PrEP) and antiretroviral treatment (ART), and self‐reported undetectable viral load (UVL) using data collected by the gay social networking app Hornet.MethodsIn 2016, the Global Forum on MSM & HIV (MSMGF) partnered with Hornet, to support an educational initiative called Blue‐Ribbon Boys. One aspect of the initiative prompts Hornet users to answer a short series of yes‐no questions about their sexual health. Using survey responses, we evaluated factors associated with PrEP and ART use as well as self‐reported UVL by fitting separate multivariable generalized estimating equation models.ResultsIn total, 16,008 unique Hornet users started the survey, of which 12,126 (76%) provided sufficient data for analyses. Of the 10,774 HIV‐negative men, 13% reported PrEP use in the past year. PrEP use was associated with a recent sexually transmitted infection (STI) test or treatment (aOR = 2.19, CI = 1.49 to 3.21); and taking steps to protect oneself from HIV (aOR = 1.41, CI = 1.13 to 1.76). Among HIV‐positive Hornet users (n = 1243), ART use was associated with older age (each year increase aOR = 1.02, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.54, CI = 2.65 to 7.78); and awareness of unlikely HIV transmission with UVL (aOR = 1.53, CI = 1.03 to 2.26). UVL was associated with older age (each year increase aOR = 1.03, CI = 1.01 to 1.04), a recent STI test or treatment (aOR = 4.84, CI = 2.74 to 8.55), and awareness of unlikely HIV transmission with UVL (aOR = 1.98, CI = 1.37 to 2.85).ConclusionsStudy findings underscore the importance of STI testing and treatment as well as information about HIV transmissibility for encouraging PrEP and ART use. Our findings also reveal age disparities, which can undermine incidence reduction among gay men. Gay social networking apps can be effectively used for rapid data collection and sexual health promotion with men who have sex with men. STI testing and treatment programmes offer important opportunities for encouraging PrEP and ART use. Information about HIV transmissibility with consistent ART use should be incorporated into prevention messaging tailored to various age groups.

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men

“…Therefore, we believe that the cisgender men who use this are gay men and other MSM. Hornet has been used as a means for conducting research on gay men and other MSM worldwide [ 20 , 32 – 34 ]. Data collection for the current study occurred from April 16, 2020 to May 4, 2020, during which time Hornet users were invited to participate in a brief questionnaire with 58 questions regarding the impact of COVID-19 on economic vulnerability, mental health, HIV prevention, testing and treatment and care impacts.…”

“…In addition, COVID-19 may amplify existing barriers that impede access to HIV prevention, testing, treatment, and care, potentially complicating slow-moving efforts to achieve global HIV targets among gay men and other MSM who remain disproportionately impacted by HIV [19,20]. Gay men and other MSM are 22 times more likely to acquire HIV than the general population worldwide [21].…”

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 response on a Global Sample of Cisgender Gay Men and Other Men who have sex with Men

“…Therefore, we believe that the cisgender men who use the app are gay men and other MSM. Hornet has been used as a means for conducting research and population size estimation on gay men and other MSM worldwide (20,(32)(33)(34). Data collection for the current study occurred from April 16, 2020 to May 4, 2020, during which time Hornet users were invited to participate in a brief questionnaire with 58 questions regarding the impact of COVID-19 on economic vulnerability, mental health, HIV prevention, testing and treatment and care impacts.…”

Building the evidence base to optimize the impact of key population programming across the HIV cascade

“…Using data collected from an online survey implemented through the gay social networking application, Hornet, Ayala et al . describe determinants of HIV service uptake among a global sample of MSM . Of the 10,774 HIV‐negative respondents, 13% reported PrEP use.…”